Dear Premier Ford:
I am writing to you about the state of health care in Ontario. I write as a Conservative, but not as an extreme right-wing whacko. In fact, I kind of like the name of that new organization in Western Canada that calls itself “Centre Ice Conservatives.” It suits me to a tee, and much better I think than ‘Red Tory’. I also voted for you in the last two provincial elections.
But we have a problem here Premier, that needs to be addressed. I know that government cannot be all things to all people. I also know that health care is a dual responsibility of both the federal and provincial governments and that the serious problems we currently face related to failures in our health care system are Canada-wide, and not just in Ontario.
I do believe however, that there are remedies that can be applied here and now under your jurisdiction. They will not entirely fix the situation, but they can certainly ease the pain.
A good start would be to repeal Bill 124, legislation that has limited salary increases to some health care professionals working in the public sector, most especially registered nurses, to 1% annually, over at least a three-year period.
It may be no coincidence that we now we have a critical shortage of nurses in our hospitals and that many nurses are leaving the profession or moving to the private sector.
During the two years of the COVID-19 pandemic, nurses, especially those in hospitals, were in the top tier of hands-on, front-line workers. Many of them are exhausted and worn out. Capping their salaries at 1% was a slap in the face then, and as inflation now tops 8% a very serious financial and morale problem today.
While I am not demeaning physicians in any way, I find it hard to rationalize that a nurse in an acute care setting, where his or her entire shift must be eyes and hands on very sick patients, receives around $50.00 an hour, while an Intensivist physician is paid around $450.00 an hour to be on call in the event they are needed for specialized services.
What is really unfortunate Premier is that hospitals today, facing a serious shortage of nurses, are having to deal with private agencies for nursing staff, paying them almost twice what they are allowed to pay their own hard-working nursing professionals.
How would you expect a nurse to feel about that, working side by side, doing the same job, with someone getting double the remuneration? Also, I ask respectfully, how does that help your budget? Wouldn’t it be better both for the morale of public service nurses and your budget, to use those funds to encourage public sector nurses by providing competitive salaries?
Here in Muskoka Premier, while the shortage of nurses in our hospitals is acute, it is not the only problem and I suspect this mirrors hospitals, big and small, throughout the province.
Our two hospitals are regularly on obstetrical and critical care bypass because of staff shortages. Diagnostic imaging often operates with reduced imaging or bypass. Respiratory therapy shifts are often left unfilled. Ambulance and paramedic services are also short staffed resulting in waiting times to respond to emergency calls. Here too, I am told that about 30% of hospital nurses are from agencies, again, at more than double the cost, plus room and board. Even respiratory therapists require expensive agency assistance. The bottom line is that people are not getting the care they need.
It occurs to me Premier, that many of the challenges we currently face in the health care sector are the result of staff shortages. For the life of me, I can’t figure out why. Pre-pandemic, we did not have nearly the level of staff shortages, in many sectors, but particularly in the health sector, that we have now. Where have they all gone and why can’t we get them back to work? To me, that is a key question.
What we need sir, is a made-in-Ontario plan for improving Ontario hospital health care. Only your harshest partisan critics will believe you can solve the problem overnight. But we do need a visible, cohesive, and clearly articulated plan, complete with objectives and timelines.
It can start with the repeal of Bill 124 so health care workers can believe they are being treated fairly and respected for what they do. It can include determining why we have lost so many health care workers and what we need to do to get them back. This may mean incentives and frankly, it may also require tough measures. We need to get healthcare workers who are already trained, back on the job. It would also be helpful to fast-track training for new professionals in the healthcare field.
Premier, people in this province are looking for real leadership here both from you and your Minister of Health who to date has seemed to be more on the defensive than in an action-oriented mode.
For those who have anger and hatred toward you and your government, you will be damned if you do and damned if you don’t. There will be no winning there. But to most of us, I truly believe, the most important thing is to see serious steps taken in areas where you have jurisdiction within the health care sector, especially in our hospitals, where you can make a positive difference and where reasonable people will thank you for it.
The problems are real Premier and with due respect to your Minister of Health, when people’s lives and well-being are at stake, as they are because of issues with our health care system, it does amount to a crisis.
That is why it is your leadership that is badly needed now.
Sincerely,
Hugh Mackenzie
Hugh Mackenzie has held elected office as a trustee on the Muskoka Board of Education, a Huntsville councillor, a District councillor, and mayor of Huntsville. He has also served as chairman of the District of Muskoka and as chief of staff to former premier of Ontario, Frank Miller.
Hugh has also served on a number of provincial, federal and local boards, including chair of the Ontario Health Disciplines Board, vice-chair of the Ontario Family Health Network, vice-chair of the Ontario Election Finance Commission, and board member of Roy Thomson Hall, the National Theatre School of Canada, and the Anglican Church of Canada. Locally, he has served as president of the Huntsville Rotary Club, chair of Huntsville District Memorial Hospital, chair of the Huntsville Hospital Foundation, president of Huntsville Festival of the Arts, and board member of Community Living Huntsville.
In business, Hugh Mackenzie has a background in radio and newspaper publishing. He was also a founding partner and CEO of Enterprise Canada, a national public affairs and strategic communications firm established in 1986.
Currently, Hugh is president of C3 Digital Media Inc., the parent company of Doppler Online, and he enjoys writing commentary for Huntsville Doppler.
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Well said, Hugh MacKenzie , and Hugh Holland. None of us can begrudge the ER Doctors’ a decent pay to a certain point. They are top notch with huge responsibilities , but $450 an hour?? ($450 x 7.5 hr shift = $3,375.00 a shift.) An ER nurse told me 14 years ago that the ER doctors were paid $197.00/hour back then! NO overhead, No staff, No rent, No phone, No hydro, No nothing! Now, our local on call specialists… that’s a whole different story…
Mr. Mackenzie and I have exchanged further messages about this article. To his credit he has supplied me with his references. His figure of $450 per hour pay comes from at least two news articles articles quoting this figure.
I apologize to Mr. Mackenzie for accusing him of spreading misinformation, when he was simply passing on figures available elsewhere.
Hugh Holland, I agree. Well said.
Well said, agreed. I agree with everything that he has said. But the health care crisis goes further than hospitals. There are nowhere near enough doctors, nurse practitioners, walk-in clinics or other health care workers here in the north. A one year wait for a pain clinic appointment in Barrie. North Bay’s pain clinic booked till Dec 2023? The approach to health care in Ontario requires vision, creativity, innovation, an entrepreneurial open-mindedness that places a value on the health, welfare, and quality of life of its citizens. Leadership. Can Doug Ford or his health Minister rise to this.
None of us have all the answers to this complex problem, but here are a few valid points to be considered.
1. We can stop wasting time talking about privatization of health care. It has been well established over and over again that US style private health care costs at least twice as much as the public system in virtually all developed countries, and the outcomes are not as good.
2. There are about 180,000 nurses (round the clock) and 130,000 teachers in Ontario. Qualified and experienced people in both professions make similar decent middle-income money. No-one, including teachers and nurses, was spared the impact of Covid. During Covid, teachers had to deal with sick kids, sick colleagues, ever changing rules, and had to manage progress with frequent switching from in-class to on-line learning. Nurses had to deal with a surge of very sick patients, sick colleagues, ever-changing rules, and abuse from people waiting too long in ERs. People often get sick or injured doing careless and stupid things, but then expect instant free care. Both teachers and nurses were concerned about their own health as well as that of their families.
3. The total cost of dealing with the Poilievre-supported Freedom Convoy is estimated to be about $6 billion including business losses due to several days of border closures. That totally wasted money could have hired another 60,000 full-time nurses or teachers with 40% or 24,000 in Ontario. Counter-intuitively, Poilievre will no doubt continue to rail on about his favourite self-serving topics, cutting government waste, regulations, and taxes, with no regard to the consequences. And he is still wasting time arguing the fine points about the necessity of the Emergencies Act. Its over and it worked. Time to move on to the many problems we can do something about, instead of playing his favourite game; pin the tail on yesterday’s donkey.
I think we all know, that whatever gets downloaded or privatized, will likely remain so, even once the party in power changes. A party may rail and fume as the government of the day slashes and dismembers a system they deem wrong, but that doesn’t mean, that when the power changes, those who previously whined, will restore what was.
Mr. Ford never displayed much leadership or political acumen, so Ontario better be prepared to make do with what this premier leaves wasted in his wake. And he’s got four, long years to do it.
I find it strange, that some people have commented here, on the wrong headedness and intransigence of our, now premier. Only a few weeks ago, these same people were trumpeting that the man was only a few pounds over being able to walk across their pool!
He hasn’t changed at all folks!
He was wrongheaded right from the beginning.
I agree Hugh, well stated
I have been a PC supporter for many years, but I have a really hard time with Bill 124.
This bill is a real slap in the face to our amazing nurses and hospital staff affected by this bill. I am really disappointed in the treatment of our well educated and overworked nursing staff throughout Ontario who are predominantly female but also male. There has been a huge strain on nursing staff well before the last 2 years of Covid. Many have endured burn out both mentally and physically. Nurses are a vital cog in our health care system. Our provincial and federal governments have to step up and compensate the nurses with compatible wage increase percentages and staffing numbers that are in line with other emergency service sectors. Mr Ford, please step up and make this change!!!
Scott MacInally
Thank you Hugh. We’re often on different sides of the issues, but I’m with you on this one. As far as I’m concerned, this situation is a preamble to privatizing health care in Ontario, to the benefit of Ford’s buddies. We know he still has a good whack of money from the federal liberals, having responded to covid late and taking off the gloves early.
I’m so saddened at the state of our province across the board. I wish we could find a leader with vision who is concerned with the needs of their constituents. Just call me Pollyanna, I guess.
Hi Hugh
Another aspect of Bill 124 (in addition to restrictions of a 1% wage increase in each year of three years and removing hard fought rights for nurses for scheduling rules etc), was that RN’s (who are predominately female) were targeted. Our hard working Police and Firefighters (predominately men) were not forced to be penalized by Bill 124.
Mr. Parrett: My figures are correct and I am not the one indulging in misinformation. You will note in my article that I referenced the COVID-19 pandemic and because I was referring to acute care settings and intensivist physicians, obviously I was referring to hospital care. To be clear, intensivist physicians, especially at night, were onsite but only on call unless specifically required for a critical issue needing a physician. Often these issues were resolved by telephone to the physician on call. When they were not required, on call physicians were able to access sleeping accommodations, provided for them on site in most hospitals. Nurses were primarily responsible for the ongoing care of these very sick patients for their entire shift. Nurses in the ICU were paid about $50.00 per hour with a whopping hourly night shift premium of $2.88. Doctors were paid $450.00 per hour whether on call or on the floor. My arguement was not and is not, what a physician is paid, but rather the discrepency between them and front-line, hands-on, profrssional nurses, in a continiously tense, highly charged and challenging environment. If you are interested, there are a number of on-line sources that will confirm that these figures are accurate and that anything I wrote in my article, or in response to Dr. Murat that I stated as fact, is precisely that.
Dave Wilkin is exactly right here. I encourage anyone who is interested to watch last week’s episode of the Herle Burly podcast, where former premiers Christy Clark, Stephen McNeil and Kathleen Wynne all discussed the state of Canadian health care. Premiers Clark and McNeil both outlined well what changes could help ensure our system’s survival. Unsurprisingly, Premier Wynne argued against these changes
https://www.youtube.com/watch?v=pZWo5Cv93Ds
So which is it, Hugh? $450 for being on call for 24 hours, or the $450 per hour you threw out in your article? I note your reply to Dr. Murat dodges the issue. If your figures are wrong, than step up and admit it and retract it in an editorial, instead of in the fine print of the remarks section. Meanwhile, many readers will go around spreading the “doctors make $450 an hour” misinformation for years.
No wonder we mistrust the media.
Big picture, Canada’s health care system is in need of significant changes. COVID19 only exposed and further stressed an increasingly stressed system. The federal transfers share of costs have been shrinking steadily for decades and now represent under a quarter of health care spending, further stressing provinces/territories budgets.
Canada spends almost 11% of GDP on health care, up about a quarter since 2000 and now sits #6 in the OECD, yet Canada remains low on hospital beds, nurses/support workers and physician’s per capita. So it’s not for lack of spending It’s more about value for money. Ontario is even lower on these key metrics compared to the national average, so yes, Ontario can and must take corrective action to slow and reverse these unsustainable trends.
The fed’s also need to step up to help, rather than continuing to download more of the cost burden while trying to dictate how to spend its shrinking cost share, worsening an already overly bloated bureaucracy.
https://financesofthenation.ca/2021/11/02/canada-is-a-big-spender-on-health-care-but-we-lag-behind-countries-in-results/
Mr. Kidd, you have understood the situation well.
RNAO (Registered Nurses Association of Ontario) could see this coming.
1] pre-pandemic, Ontario had the lowest per capita rate of nurse to person in the population in Canada!
2] pandemic, overload, burnout (this included physicians and other healthcare workers too).
3] Ford was already allowing agency (for-profits) to try to fill the need (handwriting on the wall)
For-profit agency nurses cost the taxpayer more- many went this route, leaving the non-profit healthcare because they were so exhausted and wanted more say over their schedules in order to work and survive the exhausting pandemic work.
Continuity of care suffers greatly (how a patient is nursed from shift to shift and day to day) -important because regular staff notice changes in patient’s conditions faster, rather than someone who has just landed at the facility. More opportunity for error in care and treatment by said nurses.
Some nurses left for the US and better pay. Some have retired, some have left the profession all together.
4] there was never a serious plan, post Wave 1 to enhance and incentivize the recruitment of new nurses.
It takes a minimum of 4 years to become a RN. Imagine if Ford Conservatives had started earlier – Once Again and Again, late to address the situation unfolding.
The $5000 signing bonus offered by Ford Cons would not be worth the effort of going into the nursing profession, as the public could see the toll on nurses. Education opportunities and student costs pale.
Well said Hugh.
Adding nurses and medical personnel from other countries..may help, but is a cheap way to replace long serving professional nurses.
Ford would rather do this than pay the nurses what they deserve. Ford seems to be following the dubious lead of Mike Harris by messing up the nursing system and then privatizing it.
Absolutely pay nurses what they’re worth, close to doctors wages, BUT make them pay the same amount and do the same length of education as a doctor. Apples to Apples. This added cost to their education will be used to pay their salaries so the taxpayers like me who can’t pay a dime more or go bankrupt don’t have to foot the bill.
With all due respect Dr. Murat, I do have my facts straight. As I said in my article, I am not demeaning physicians in any way, but I did do my homework and I do know that there are hands on, fully occupied professional nurses working in Intensive Care Units in Ontario, making about $50.00 an hour while intensivist physicians are on call in case they are needed at about $450.00 per hour for the same shift. That is all that I said. My point was the dichotomy between the two and not as you have implied, a statement that physicians in this province are rich. My article was about nurses Dr. Murat, and not about physicians; about nurses that currently have no real collective bargaining rights and, by the way, have to pay for parking at hospitals the same as you do.
Mr. Mackenzie; Thank you for this opportunity to give readers a “head’s up” with what is to come.
For those who are interested, here are some indicators to watch for (or facsimile thereof) with the Ford Conservatives:
Mike Harris Conservative process to starve public health care: a real example.
1] decide which sector of health you wish privatized (community health services in this case)
2] mandate the acceptance of RFPs and contracts for home care services from for-profit interested parties
3] mandate the increased frequency of the bidding opportunities (e.g. every 6 months/1 year) and increase the hours of service for which for-profits can bid. This phases out the non-profits over a few years and causes the worker to re-apply for the same job at a lesser wage.
Poor MH, such a tough decision (to be read with sarcasm).
Here is the immediate and long term fallout:
1] loss of scheduling jobs-provided locally, service must be a call centre in another geographical area (in this case, Peterborough for Muskoka).
2] unionization of a non-profit, previously un-unionized. Workers fear the loss of job, hours, wages – a no-brainer, predictable result
3] for the Ontarian receiving services =
-a steady parade of different Community Health Workers coming to their home, with a loss of sense of trust and security.
-missed visits, due to poor scheduling or lack of worker availability
With a missed visit this may include the lack of a weekly (only) bathing, lack of application for the day of treatment stockings, laying in a wet, soiled adult incontinence product for hours, skin breakdown, and infection.
4] worker demoralization, that they are unable to properly care for their clients/patients.
We are in for trouble when our Minister of Health has no experience or understanding of this sector.
She does have a diploma in radio communication from Fanshaw however, will this be enough?
I for one, do not imagine so.
Thank you for reading.
One point that doesn’t seem to be mentioned in the media is the fact that nurses have the right to collective bargaining which they received almost fifty years ago when they formed a union and became part of the labour movement; if negotiations are unsuccessful, they go to arbitration which allows both sides to participate and hammer out an agreement; they are not allowed to strike, but they do have certain rights under labour law.
For some unknown reason, the government of Ontario decided to take those rights away by passing legislation that controlled what nurses (and some other public sector groups) would be allowed to get as a wage increase; this action is more than a slap in the face, it is a autocratic and it is discriminatory.
Why would government wipe out the labour rights of one group of citizens with the stroke of a pen, while all other members of the labour movement are not affected; it is a betrayal of a trust that everyone will be treated fairly and equitably.
Hugh, it never seems to phase anyone when someone like you suggests that a physician can actually earn $450 an hour without doing anything but to be available. That is $10800 per day. Most physicians would have a very busy day if they gross billed $1000 dollars a day. That’s seeing patients all day and before expenses. The Hospital on Call money you refer to is a sum of money paid every 24 hours to the one physician who is available for 24 hours that day. That is around $500 per day. If the physician does not get called then that will be the earnings for the day. This works out to $20 per hour. Get your facts straight and stop suggesting that the physicians of this province are rich. We work long hours and see a lot of people to make a good living. We have no pension, no benefits, no sick pay, no workman’s comp, no drug plan, no extended health benefits, no car allowance, and no free parking.
Indeed, Hugh Mackenzie, this letter to DF is very well articulated. I too, hope DF sees this and takes action. What a pleasant surprise that would be!
Well said Hugh ! Much better than constant non constructive criticism that seems pervasive these days . I know Our New MPP is listening .
Hugh: I really do appreciate what you say; much along the lines of how I feel. There is however the problem; that there is no real training or degree you can achieve to be a politician. We pay our money and we take our chances. And we are being short-changed.
Christine Elliot was hung out by the Conservatives, while the premier slagged on nurses, and the aged and infirm perished. Supposedly, there was no need for more money in the system. Now, a media student gets to do the job and the bankroll is, supposedly, assured.
Stephen Lecce was a political science student and becomes Minister of Education. Michael Ford was a councilor and is the premiers nephew!!! Neil Lumsden was a football running back!! Go figure. Big in entertainment?
Peter Bethenfalvy actually had a financial background, though with this government, I don’t feel any sense of security.
Our local MPP was a local mayor, and is now in charge of trees and rocks. And the central character in our local ‘Turtlegate’.
I am aware that a person can perform in a variety of fields, but it might be more reassuring to have someone working in their field of expertise.
I loved the way our premier dealt with that nasty gnat. Just ate it! An example for the rest of the members of the crew at Queens Park?
And Kathryn Henderson and Bob Slater: maybe you could get together and have a group scream? Things seem bleak from your side of the conversation.
Still, I really like the gnat bit(e).
Well said Hugh.
Too bad there wasn’t a clone or two of the very effective minister of education, Stephen Lecce, to lead the Ministry of Health and others.
At any rate we are all waiting for the gushing praise for nurses and long term care workers going back to the first wave of the pandemic to be put into action in the form of monetary compensation. People who look after us in our vulnerable years,
often dirty unpleasant work, should be viewed as worthy of respect and gratitude and much better than only minimum wages. As has been shown they are essential to the care of our elderly (soon to be us!) These people should not have to work two or three jobs to live a decent life.
We have seen where that leads.
We have to live up to the promisses made two years ago.
Good subject Hugh.
Hugh, well done. You have articulated the problem in an even handed, positive way, I wish premier Ford would listen, especially coming from a committed true blue Tory…it just makes so much sense. Ford gave us free licence plates..why.? That money could have gone to nurses! Not amorphous “health care”, but nurses!!! 1% is an insult, especially with inflation running upwards of 8%.
Thanks, Hugh. Hope he sees this and listens.
Hugh.
Hard to believe that was written by a die hard conservative like yourself.
Like many in Muskoka I have voted Blue.
Do you actually think Doug Ford aka Mike Harris is listening?
Ford would rather give the funds too for profit nursing homes to be
directed as dividends to stock holders. Could I be wrong?
Excellent article. just wished someone was actually listening.
Well said Hugh! I just don’t understand the premier’s thinking in the nurses situation.
After the pandemic , stress, strain and a 1% increase is a slap in the face .
You need to Repeal bill 124 and show your respect and support for the services they provide.
Doug this is not a hard decision. Just do it! For the better good of the community and nursing staff.
Long over due.